Davis Levin Livingston Sues Kaiser For Failure to Pay Medical Benefits Due to Maui School Teacher

HONOLULU – A Maui High School science teacher and his wife are suing Kaiser Foundation Health Plan Inc. and other heath care entities, alleging doctors misdiagnosed his rare form of cancer and later refused to cover the costs of treatment elsewhere that saved his life.

The complaint says that Kaiser did not properly diagnose Michael Siopes’ neuroendocrine cancer and “embarked on an improper and potentially disastrous course of treatment,” according to a statement Wednesday afternoon from the law firm of Davis Levin Livingston.

Kaiser spokeswoman Laura Lott said Kaiser could not comment because the case is in litigation.

Attorneys for Siopes said that the Kaiser physician in charge of his care “candidly admitted that he had never seen or treated Michael’s type of cancer,” which was neuroendocrine carcinoma of the gastroesophageal junction.

“Even though Kaiser recognized that Michael suffered from an extremely rare and deadly form of cancer, it failed to schedule a timely consultation with an oncologist or provide Michael with his requested second opinion,” Siopes’ law firm stated in a news release.

The law firm said Michael and Lacey Siopes decided to seek a second opinion from physicians experienced with neuroendocrine cancer. They flew to Duke University Medical Center in North Carolina where Michael Siopes was evaluated, properly diagnosed and received appropriate treatment. He was hospitalized from March through June 2010. During that time, his tumor was reduced through radiation treatment and removed.

Today, Siopes, a 42-year-old Haiku resident, is cancer free and has returned to teaching at Maui High.

But his attorneys said Kaiser has refused to cover the cost of Siopes’ medical treatment, although that is required by state law and by Kaiser’s health insurance plan. He has been a member of Kaiser since 1994.

“Faced with mounting medical bills, Michael’s friends, students and community have provided assistance to protect the Siopes family from financial ruin, including holding a fundraiser at Ruby’s Diner in Kahului,” the law firm said.

The Siopes family faces more than $277,000 in medical bills, said attorney Matthew Winter.

“The long struggle of this family to obtain the medical care they contracted to receive from Kaiser has had a devastating emotional and financial impact on their lives,” Winter said. “We all hope that this case will resolve Kaiser’s obligation to its patients and will serve as a disincentive to mistreat the members of its health plan.”

The lawsuit was filed in 1st Circuit Court on Oahu. Siopes’ attorneys are seeking the cost of his medical bills, as well as special, general and punitive damages to be proven at trial, along with attorneys’ fees.